Reported Child Abuse Research Articles

0381 Adverse Childhood Experiences Associated with Adult Sleep Duration, Control Over Sleep, and Daytime Sleepiness

Abstract Introduction Adverse childhood events have been linked with many mental and physical health risks, but less work has explored nighttime and daytime sleep problems, especially inability to control sleep. Methods Data were obtained from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults aged 22-60 years recruited from communities in southeastern Pennsylvania. Adverse childhood experiences were defined as a self-reported history of child abuse, parent divorce, parent death, parent with depression, parent with anxiety disorder, and childhood poverty (yes/no). Habitual sleep duration was assessed in hours, daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS), and control over sleep was assessed with the Brief Index of Sleep Control (BRISC). Covariates included age, sex, race/ethnicity, and education. Additional models included depression severity, assessed using a modified version of the Patient Health Questionnaire-9. Results History of child abuse was associated with 23 fewer minutes of nighttime sleep (p=0.001), and parent anxiety was associated with 15 fewer minutes (p=0.048). When depression was added to the model, the effects for sleep duration were attenuated (15.3 minutes, p=0.03). No other relationships were observed. Regarding control over nighttime sleep, decreased sense of control was reported by those who experienced child abuse (B=-0.4, p< 0.0005), parent divorce (B=-0.1, p=0.035), and parent depression (B=-0.2, p=0.02). After adjusting for depression, the relationship with child abuse was attenuated but maintained (B=-0.2, p< 0.0005). Elevated ESS scores were seen in those who reported child abuse (B=4.7, p< 0.0005), parent depression (B=4.3, p< 0.0005), and parent anxiety (B=3.9, p< 0.0005). After adjusting for depression, relationships were attenuated but maintained for child abuse (B=2.0, p=0.02), parent depression (B=2.2, p=0.004), and parent anxiety (B=2.2, p=0.017). Conclusion Adverse childhood events may lead to sleep/wake dysregulation, including less sleep at night, more sleepiness during the day, and decreased sense of control over sleep ability. Future efforts might focus on increasing control over nighttime sleep and reducing daytime sleepiness. Support (if any)

Longitudinal changes in the county-level relationship between opioid prescriptions and child maltreatment reports, United States, 2009-2018.

This article examines whether county opioid prescription rates were associated with county child maltreatment report (CMR) rates in the United States and whether this relationship changed over time. We linked multiple national data sets to assemble retail opioid prescription data, CMR data, rural-urban codes (to control for urbanicity), and census data (to control for other community characteristics, such as poverty rates) covering 2009-2018. Multilevel linear modeling analyzed the linked data. We found that the strength of the county-level relationship between opioid prescription rates and CMR rates increased almost linearly during the study period. The relationship was not significant in 2009-2011; it became significant in 2012 and grew stronger in the next 6 years. In 2012, there was one more CMR per 1,000 children in a county for every 14.3 more opioid prescriptions per 100 people. In 2018, the number of prescriptions related to this effect was 3.6. In other words, the county-level relationship between opioid prescriptions and CMRs was four times as strong in 2018 as it had been in 2012. This trend was also observed within all subgroups of child age and sex. By type, this trend was somewhat more pronounced for neglect, but somewhat less for sexual abuse. Our findings suggest a growing need for greater efforts to prevent child maltreatment in communities with high opioid prescription rates. Further research is warranted to reveal the underlying factors for this concerning trend. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Maternal history of maltreatment and offspring's emotional and behavioral problems in adolescence: Do family factors contribute to the intergenerational risk transmission?

BackgroundA history of childhood maltreatment often has a negative and long-lasting impact across different domains in life. A childhood maltreatment experience in parents may even affect the next generation. So far, the effects of family factors have been considered in the intergenerational transmission of adversity across the childhood years, but whether the effects remain until adolescence is less clear. ObjectiveUsing data from a large population-based study in the Netherlands, including both mother and child reports, we examined whether maternal childhood maltreatment history is associated with increased mental health problems in offspring and the role of family functioning and harsh parenting as a potential pathway. Participants4912 adolescents (aged 13 years) and their mothers were recruited in the Generation R study. MethodsMothers reported childhood maltreatment experiences using the Childhood Trauma Questionnaire (CTQ), and adolescents reported on their mental health using the Youth Self Report (YSR). Structural equation modeling (SEM) was used to test the association of maternal childhood maltreatment on mental health problems in offspring and family functioning and harsh parenting as mechanisms to explain this association. ResultsAdolescents of mothers with a history of maltreatment had greater internalizing (β = 0.07, p < .01) and externalizing problems (β = 0.08, p < .01). Moreover, we found an indirect effect via family functioning over time and harsh parenting at ages 3 and 8 years which mediated this association. ConclusionWe concluded an intergenerational effect of maternal childhood maltreatment on adolescents internalizing and externalizing problems. The findings might enable earlier intervention within the family context to mitigate the consequences of maternal childhood maltreatment.

County-Level Relationships Between Foreign-Born Residents, Latinos, Immigration Enforcement, and Child Maltreatment Report Rates in the United States, 2015-2018.

U.S. Latino and foreign-born populations show lower child maltreatment report (CMR) rates despite their low socioeconomic positions, perhaps due to protective cultural factors within these populations. However, discriminatory Immigration and Customs Enforcement (ICE) activities may attenuate such protection. We examined how ethnic and foreign-born compositions and local ICE activities were associated with community CMR rates, overall and within racial/ethnic groups (i.e., White, Black, Latino), and how these associations changed over time. We used national county-level data linking multiple administrative/archival data sources (i.e., CMR, Census, and ICE data) longitudinally for 2015 to 2018 across the United States. Multilevel (county-years, counties, and states) models estimated how percentages of Latino, percentages of foreign-born, and ICE arrest rates were related to overall and race/ethnicity-specific CMR rates among counties while adjusting for a range of demographic, socioeconomic, child care burden, health insurance, residential mobility, and urbanicity factors. Higher percentages of foreign-born residents within counties were significantly associated with lower CMR rates, both overall and within all racial/ethnic groups. These protective associations became significantly stronger over the study period. Higher percentages of Latino residents were significantly associated with lower total and White CMR rates but not with Black or Latino CMR rates. The interaction between the percentage of Latino residents and year was not significant. ICE arrest rates showed no significant associations with CMR rates. Our findings suggest that communities with more foreign-born and Latino residents may be more protective against CMRs. While the foreign-born and Latino concentrations were both independently predictive of decreased CMR rates, the protective associations of the foreign-born concentration were more consistent within racial/ethnic groups and grew stronger over time. These findings suggest the need to investigate community-level protective mechanisms that may explain these results. The null findings for ICE activity also require further research with alternative measures of discriminatory state action.

Evidence for intrathymic and neuroimmune alterations in a mouse model of neglect-related early life stressors

Abstract Environmental exposures during the impressionable early life period can influence biological and behavioral development. These exposures accumulate from birth and comprise the exposome, which impacts health and disease. Neglect is a major source of early life stress (ELS) and accounts for 80% of reported child abuse in the United States. Forms of neglect vary (e.g., physical, medical, emotional, nutritional) and with increased concerns for abuse during the COVID-19 pandemic, we require a deeper understanding of how ELS affects immune system programming/development. T cells undergo a stringent selection process in the thymus to achieve self-nonself discrimination capacity and can be identified based on double-positive (DP) or single-positive (SP) CD4/CD8 expression status. We utilize a maternal separation with early weaning paradigm to study the effects of ELS on anxiety/depressive behavior and intrathymic T cell distribution. Conditions of neglect-related stress were simulated based on scheduled dam-pup separation (physical neglect) and early weaning to a high carbohydrate diet (malnutrition). Pups were subjected to one of two distinct ELS conditions: (1) daily separation with early weaning (MSEW) or (2) early weaning alone (EW) at postnatal day (PD) 14. Control pups experienced no separation and were maintained on the dam’s milk to the standard wean date (PD21). Body metrics and tissues were collected at PD21. Behavioral phenotypes were assessed at PD28–35. The results demonstrated significant stress effects and revealed an altered distribution of thymocytes within DP and SP compartments. This study provides preliminary causal evidence and provokes questions about ELS-mediated consequences on T cell immunity. NIH/NIA T32 AG020494 NIH/NIMHD 5U54MD006882-10 UNTHSC MIG Dept. Intramural Grant

Nursing students'attitudes towardreporting child abuse and neglect: A cross-sectional study in Turkey.

Nurses are uniquely positioned to provide early diagnoses and interventions for abused, neglected, or at-risk children. They are also required, by law, to report suspected child abuse. However, little is known about the attitudes of student and registered nurses in reporting cases of abuse. This study aimed to identify nursing students'attitudes and related factors towardreporting child abuse and neglect in Turkey. This cross-sectional study was carried out with the online participation of 1170 nursing students. The scale for determining the attitudes of health professionals in reporting child abuse (ACAS) was administered together with questions on demographic information. ACAS scores of nursing students towardreporting child abuse were average. Younger age, poor perceived academic success, suspecting of a child abuse and neglect case during clinical practice, and male sex were independently associated with higher ACAS scores. Therefore, education programs for nursing students should focus on improving their attitudes toward reporting child abuse and neglect.

Understanding the Effects of COVID-19 on Child Maltreatment Reporting Among Rural Versus Urban Communities in the United States

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted child protective services (CPS) reporting systems in the United States. It may have also led to widened gaps between rural and urban communities in child maltreatment (CM) report rates due to decreased interaction between children and mandated reporters especially in urban jurisdictions. Using data from the National Child Abuse and Neglect Data System, this study tests the hypothesis that during the onset of the COVID-19 pandemic, the decrease in CM reports made to CPS in urban counties was more pronounced than in rural counties. Reports of CM received by CPS offices between January 6, 2020 and June 28, 2020 were aggregated to per-county-per-week-per-10,000 children maltreatment report rates. We used changepoint analyses to analyze the inter- and intra-region incidence rate ratios among rural and urban counties. Moreover, we used multilevel random effects models to generate regression coefficients for the associations between rates of children with a maltreatment report, COVID-19 occurrence, rural-urban designation, and maltreatment risk factors. During the study period, rates of children with a maltreatment report among urban counties decreased more dramatically when compared with rural counties. Our findings persisted even with the inclusion of control variables associated with maltreatment risk factors. Social distancing restrictions may have had the unintended consequence of decreasing the visibility of at-risk children in urban counties more so than in rural counties. Considering geography is critical to continue to protect children during the COVID-19 pandemic and as we prepare for future disasters.

Examining the roles of rurality and Latine ethnic density on child maltreatment report and substantiation rates among Latine families: A county-level analysis

ABSTRACT Evidence of geographic variation in child maltreatment report rates among Latine families is growing. This study investigates whether structural community characteristics, namely rurality and Latine ethnic density, associate with variation in Latine child maltreatment rates across 925 US counties. Using ten years of cross-sectional data from the National Child Abuse and Neglect Data System (NCANDS), ACS and USDA, OLS regression models examined rurality and Latine density’s association with child maltreatment report and substantiation rates. Rurality associated with increased maltreatment rates; however, Latine ethnic density buffered this across most maltreatment subtypes. Results highlight a complex interaction between ethnicity, rurality, and maltreatment.

Genetic Decomposition of the Heritable Component of Reported Childhood Maltreatment

BackgroundDecades of research have shown that environmental exposures, including self-reports of trauma, are partly heritable. Heritable characteristics may influence exposure to and interpretations of environmental factors. Identifying heritable factors associated with self-reported trauma could improve our understanding of vulnerability to exposure and the interpretation of life events. MethodsWe used genome-wide association study summary statistics of childhood maltreatment, defined as reporting of abuse (emotional, sexual, and physical) and neglect (emotional and physical) (N = 185,414 participants). We calculated genetic correlations (rg) between reported childhood maltreatment and 576 traits to identify phenotypes that might explain the heritability of reported childhood maltreatment, retaining those with |rg| > 0.25. We specified multiple regression models using genomic structural equation modeling to detect residual genetic variance in childhood maltreatment after accounting for genetically correlated traits. ResultsIn 2 separate models, the shared genetic component of 12 health and behavioral traits and 7 psychiatric disorders accounted for 59% and 56% of heritability due to common genetic variants (single nucleotide polymorphism–based heritability [h2SNP]) of childhood maltreatment, respectively. Genetic influences on h2SNP of childhood maltreatment were generally accounted for by a shared genetic component across traits. The exceptions to this were general risk tolerance, subjective well-being, posttraumatic stress disorder, and autism spectrum disorder, identified as independent contributors to h2SNP of childhood maltreatment. These 4 traits alone were sufficient to explain 58% of h2SNP of childhood maltreatment. ConclusionsWe identified putative traits that reflect h2SNP of childhood maltreatment. Elucidating the mechanisms underlying these associations may improve trauma prevention and posttraumatic intervention strategies.

The Dimensions of the Best Interest of the Child in Albania

The principle of the best interest of the child is a fundamental principle in international and national law, which requires that in all actions concerning children, their best interests must be a primary consideration. Albania is still a patriarchal society, and traditional cultural norms and practices sometimes conflict with children's rights and welfare. The aim of this paper is to address the challenges related to cultural and social norms and to fully implement the principle in Albanian context. In Albania, this principle is enshrined in various legal instruments, including the Constitution, the Family Code, and the Law on the Protection of Children's Rights etc. As a result, the paper analyses the principal of best interest of the child in custody and guardianship cases, adoption proceedings, divorce process and child protection cases. In this context, the paper is focused in “Balancing the elements in the best-interests assessment”. However, despite these legal and institutional frameworks, Albania still faces challenges in fully implementing the principle of the best interest of the child. One of the main challenges is the lack of resources and capacities to adequately protect and promote children's rights, particularly for marginalized and vulnerable children. The COVID-19 pandemic has also exacerbated these challenges, with increased reports of child abuse and neglect. In these conditions, the paper presents appropriate recommendations in order to have full implementation of this principle in Albania.&#x0D; &#x0D; Received: 4 January 2023 / Accepted: 25 February 2023 / Published: 20 March 2023

Knowledge and Attitudes Towards Child Abuse and Neglect Among Dental Students from North Macedonia

Introduction. Signs of child abuse and neglect are often found in the orofacial region and, therefore, it is very important for dental students, as future dentists, to recognize and report them.&#x0D; The aim of the study was to investigate the knowledge and attitudes towards child abuse and neglect among dental students.&#x0D; Material and Methods. The study was performed at the Faculty of Dental Medicine, Saints Cyril and Methodius University, among all dental students of the six-year undergraduate dental programme. The data were collected between January and February 2022 using a Google Form and shared via available social media platforms. The definition of physical indicators of abuse, awareness regarding legal and ethical issues, students’ experience of child abuse recognition were evaluated by a questionnaire.&#x0D; Results. The questionnaire completion rate was 70%. As many as 20.86% of dental students very rarely received training on recognizing and reporting child abuse and neglect; 79.75% of dental students had never received any information about child abuse during their university education; about 91.41% of students wanted to receive more knowledge about child abuse and neglect. No differences were observed in terms of gender and year of study.&#x0D; Conclusions. Dental students in North Macedonia are not sufficiently prepared for their role in diagnosing suspected cases of child abuse. An educational program about diagnosing, reporting, and preventing child abuse and neglect should be involved in the curriculum of undergraduate students from North Macedonia.

Dentists’ Recognition of Child Abuse and Neglect and Mandatory Attitude to Report

In this study, the recognition of child abuse and neglect (CAN) and reporting attitudes of general dentists and pediatric dentists in Korea were estimated. A survey was conducted among dentists working at clinics or university hospitals, including interns and residents at dental hospital training institutions. The questionnaire, consisting of 32 questions and detailed questions, subdivided into ‘general characteristics of respondents’, ‘CAN’, ‘CAN report’, ‘laws to CAN’, ‘countermeasures against CAN’. The survey was conducted using a messenger, and 176 respondents’ answers were analyzed. The recognition of CAN showed high scores in the order of physical abuse, neglect, and emotional abuse. The positive attitude toward reporting CAN had a higher score than the negative attitude. Of the total respondents, 19 said they reported child abuse, and 18 said they were suspected of child abuse but hesitated to report it. Among the laws related to CAN, the protection measures for CAN reporters and the protocol for CAN showed low awareness. Since then, they have wanted to know how to find abused children and how to deal with them in education. This study is expected to be used as data to improve dentists’ awareness and consciousness of CAN in the future.

Self‐justification in decision‐making: Chinese child welfare workers' inconsistency of perceptions and experiences matters in reporting child abuse

AbstractMandatory reporting is the central measure for child protection. However, the common alternative strategy of avoidance that is practised by child welfare workers is little discussed. This study examines the influences of child welfare workers' inconsistent perceptions and experiences on reporting. Using China Social Work Longitudinal Study 2019, a total of 2 180 child welfare workers in the child and youth service field were selected. Multinomial logistic regression was used to examine the perceptions and experiences associated with reporting. Child welfare workers with a moderate perception of sexual abuse (OR = 1.442*), more experiences of emotional abuse cases (OR = 1.258*) and fewer experiences of sexual abuse cases (OR = 0.703*) had greater odds of reporting than not reporting, and those with a low or moderate perception of emotional abuse (OR = 3.027*; OR = 1.691*, respectively), a moderate perception of physical abuse (OR = 1.537*) and more experiences of neglect cases (OR = 1.345*) were more likely to avoid than to not report. Social work licensure plays a moderating role. The results indicate the importance of alternative strategies, perceptions and experiences in the assessment‐decision continuum of reporting. The inconsistent perceptions and experiences of child welfare workers contribute to self‐justification in decision‐making. Implications for practices and directions for future research are discussed.

Childhood Abuse, Intimate Partner Violence in Young Adulthood, and Welfare Receipt by Midlife.

To investigate prospective associations between type of child abuse (physical, sexual, both), timing (childhood, young adulthood, both), and welfare receipt into middle-age. Database linkage study using the Quebec Longitudinal Study of Kindergarten Children cohort born in 1980 and government administrative databases (N = 3020). We assessed parental tax returns, family and personal background characteristics (1982-1987). At age 22 years, participants answered retrospective questionnaires on experienced childhood abuse (physical, sexual abuse < age 18 years) and intimate partner violence (IPV) (ages 18-22). Main outcome was years on social assistance, on the basis of participant tax returns (ages 23-37 years). Analysis included weights for population representativeness. Of 1690 participants (54.4% females) with available data, 22.4% reported childhood abuse only, 14.5% IPV only, and 18.5% both. Prevalence of childhood physical, sexual, and both was 20.4%, 12.2%, and 8.3%, respectively. Adjusting for socioeconomic background and individual characteristics, we found that childhood physical abuse alone and physical or sexual abuse combined were associated with a two-fold risk of welfare receipt, as compared to never-abused (adjusted incidence risk ratio 2.43, 95% confidence interval [CI], 1.65-3.58; and adjusted incidence risk ratio 2.04, 95% CI, 1.29-3.23, respectively). Repeated abuse (childhood abuse combined with adult IPV) had a three-fold risk (adjusted incidence ratio 3.59, 95% CI, 2.39-5.37). Abuse across several developmental periods (childhood and young adulthood) is associated with increased risks of long-term welfare receipt, independently of socioeconomic background. Results indicate a dose-response association. Early prevention and targeted identification are crucial to preventing economic adversity that may potentially lead to intergenerational poverty.

Almost 2 years into the COVID-19 pandemic: an update on parental stress, parent mental health, and the occurrence of child maltreatment

Increased parental stress, poorer mental health, and an increase in the occurrence of child maltreatment (CM) have been reported in earlier phases of the COVID-19 pandemic. However, data from later phases of the pandemic are not yet available. We conducted a cross-sectional, representative survey among 1087 parents (48.8% female; mean age 41.72 years, SD = 9.15) in Germany in December 2021. Data were compared to a previous representative sample, assessed in August 2020 (N = 1024), and to normative scores of the outcome measures. Predictors for the occurrence of CM were analyzed by logistic regression. Pandemic-related stress and general stress were higher and physical and mental health were poorer in the December 2021 sample than in the August 2020 sample. Occurrence rates of CM varied between 5 and 56%. Verbal emotional abuse (n = 607, 56%), witnessing domestic violence (n = 446, 41%), and emotional neglect (n = 435, 40%) were most frequently reported. For these subtypes, parental risk for alcohol abuse (OR 2.1–2.7) and parental recent experience of violence (OR 2.1–5.1) were the strongest predictors. Across all subtypes of CM, parents reporting child maltreatment showed poorer scores on all stress outcomes, with medium–large-effect sizes. Results confirm a high burden within the families, almost 2 years into the pandemic. Occurrence rates of a broad spectrum of CM subtypes raise further concerns for the well-being of children. Family-oriented intervention efforts are needed to stabilize families and provide targeted support. Longitudinal studies are needed for a description of families at risk for poorer outcomes.

Knowledge, attitude, and practice regarding child maltreatment amongst Iranian medical students through internship course: an 18-month longitudinal study

BackgroundChild maltreatment has been a major worldwide problem and has remained a persistent public health challenge in all countries. Physicians have a significant role in the prevention and intervention of child maltreatment. An educated physician that can effectively identify and report child maltreatment can fill one of the most significant gaps in reducing child abuse.This study was performed to examine the knowledge, attitude, and practice regarding child maltreatment among Iranian medical students through an internship course.MethodAll the medical students (235 students) of the Iran University of Medical Sciences who passed the internship entrance exam in the 2019–2020 academic year participated in this study. The participants completed a 49-item scale questionnaire built by combining three other validated questionnaires that evaluate their attitude, knowledge, and practice skills in the first month of their internship course and then completed the same questionnaire 18 months later, at the end-point of the internship period.ResultsOne-hundred thirty nine (59.1%) participants were female, and 96 (40.9%) were male. The mean age of the subjects was 24.35 ± 0.76. Only 7 (3%) of them formerly received any education about child maltreatment. There was a significant improvement in scores of the knowledge of prevention (p-value = 0.001), the practice of prevention (p-value < 0.001) and the general subscale of the practice section (p-value < 0.001) during the internship course. However, the performance of participants decreased significantly in the subscales of the attitude towards diagnosis (p-value = 0.001) and the attitude towards reporting (p-value < 0.001) of child maltreatment. At the end of the study, the result of graduated physicians was: The total knowledge and attitude of participants were satisfactory, and the majority were at reasonable levels. Although in the practice subscale, 70.6% of the participants didn’t identify, 84.7% didn’t refer, and 86.4% didn’t report a child abuse case in the past year.ConclusionThe knowledge and attitude of Iranian physicians regarding child maltreatment are at a satisfactory level. Although, the practice level has deficiencies. In addition, our findings show that Iranian interns have a shallow experience regarding child maltreatment, particularly despite the higher scores in attitude and knowledge, which can be the reason for deficiencies in the practice level.

Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry.

Child abuse and neglect (CAN) is a major threat to the health and well-being of children throughout the world. Apart from healthcare professionals, teachers also play an important role in recognizing and reporting child abuse as they are in a better position to observe the behavioral changes in children as they spend substantially more time at school. The aim of this study was to evaluate the effectiveness of a video tutorial program in improving the knowledge of school teachers on CAN. A cross-sectional questionnaire-based study was conducted among the 79 school teachers of Puducherry. At baseline, a prevalidated questionnaire was used to assess the knowledge of the school teachers on CAN. After the intervention, the same prevalidated questionnaire was repeated. The mean knowledge score of teachers before intervention was 9.13. After video intervention knowledge score was improved to 14.46 (p < 0.05). The study showed that a knowledge deficit exists among teachers regarding CAN, and the video tutorial program was found to be effective in improving the knowledge of school teachers. The government, as well as the schools should take the initiative to create awareness among teachers. Shivashankarappa PG, Pitchiah PA, Adimoulame S. Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry. Int J Clin Pediatr Dent 2022;15(5):575-578.

Awareness, Reporting Intention, and Reporting Attitude toward Child Abuse in University Students

The aim of this study was to investigate university students' awareness, reporting intention, and reporting attitude towards child abuse and neglect. A cross-sectional study was conducted by web-based survey of 333 university students. The collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation in SPSS 26.0. The mean scores of child abuse awareness and reporting intention were 6.13±0.75, and 5.58±1.02 respectively. The mean score of effectiveness and obstacles in attitude toward reporting were 3.14±0.75 and 2.79±0.79 respectively. Students were most aware of physical abuse and showed the intention to report it; however they did not have a high awareness and reporting intention for neglect or emotional abuse. Child abuse awareness and reporting intention were significantly positively correlated and obstacles in attitude toward reporting had a negative correlation with awareness and reporting intention. Therefore, education to raise awareness of child abuse targeting university students and attempts to lower the obstacles related to reporting child abuse should be made together.

Changes in Household Challenges and Subsequent Child Welfare Report

Preventing child maltreatment and reducing adverse childhood experiences is critical for improving adult health. To inform prevention efforts, it is necessary to move beyond static risk models and instead model the dynamic changes in household challenges during the prebirth and early childhood periods. This study examined the effect of changes in the number of household challenges from prebirth (12 months before birth of a child) to early childhood (3 years after birth) period on the risk of a child maltreatment report by age 3 years. This retrospective cohort study linked data from the Alaska 2009-2011 Pregnancy Risk Assessment Monitoring System, its 3-year follow-up survey, and administrative records through 2019. Participants were 1,699 birthing parents. Latent class analyses identified prebirth and early childhood low- and high-challenge respondent groups on the basis of the level of reported household challenges. The authors then modeled the relationships between group transition membership and the risk of maltreatment using latent transition analysis. Analyses were conducted in 2021. Households transitioning from a high-challenge-prebirth status to a low-challenge-early-childhood status had a lower predicted risk for child services report than households remaining in the high-challenges group. Transitioning from low- to high-challenges status predicted the highest risk for child services report than that of all other groups. To reduce the risk of child maltreatment and subsequent adverse childhood experiences, healthcare providers should screen parents for the presence of household challenges during both pregnancy and early childhood and connect patients to resources targeted at reducing those challenges and providing continuous familial support.

Examining the Relationship Between Trauma, Post-Traumatic Stress Disorder and Psychosis in Patients in a UK Secondary Care Service.

Traumatic experiences and post-traumatic stress disorder (PTSD) are common in schizophrenia. However, few studies screening for PTSD have established the temporality of PTSD-related traumatic events to psychosis onset. Furthermore, it is unclear how many patients attribute a trauma-based contribution to their psychosis or would find trauma-focused therapy acceptable. We examine the prevalence and timing of trauma in psychosis, as well as patient views on the relationship between their trauma experiences and mental health difficulties, and on receiving trauma-focused therapy. Sixty-eight patients with an at-risk mental state (ARMS) or psychotic disorder in a UK secondary-care setting completed self-report measures of trauma and PTSD, and undertook research interviews. Proportions and odds ratios were derived with 95% confidence intervals. We recruited 68 participants (estimated response rate 62%; psychotic disorder n=61, ARMS n=7). Sixty three (95%) reported traumatic events and 32 (47%) reported childhood abuse. Twenty-six individuals (38%) met criteria for PTSD, though for >95% this was not recorded in their notes, and 25 (37%) had sub-threshold PTSD. For 69% of participants, their worst trauma occurred before the onset of their psychosis symptoms. Most (65%) believed their psychosis symptoms were related to past traumas and 82% of these were interested in receiving trauma-focused therapy. PTSD is common in and often pre-dates onset of psychosis. Most patients believe their symptoms and traumas are related and would be interested in trauma-focused therapy if available. Studies evaluating the effectiveness of trauma-focused therapies for those with or at high-risk of psychosis are required.